You might think your kids are getting enough vitamin D but a 2009 study published in Pediatrics found that 9 percent of kids ages 1 to 25 were deficient in vitamin D and 61 percent were low. The researchers linked their findings to increased cardiovascular risk.
Kids with levels less than 30 ng/mL of vitamin D were more likely to have low serum calcium and HDL (good cholesterol) and higher blood pressure…
Research findings suggest that low levels of vitamin D may contribute to Crohn’s and other inflammatory bowel diseases. This inexpensive vitamin, actually a hormone, may alleviate Crohns symptoms in some patients. And because Crohns often has a genetic components, taken prophylactically, vitamin D may prevent Crohn’s’ siblings and offspring from manifesting the disease.
Crohn’s is a chronic condition characterized by inflammation and ulcers (open sores) along the innermost layer of the digestive tract. Inflammation can appear along the entire gastrointestinal tract (from the mouth to anus), although the majority of cases involve the small intestine or the first part of the large intestine. The cause of the disease is largely unknown; although genetic and environmental factors may play a role.
Vitamin D, in its active form (1,25-dihydroxyvitamin D), is a hormone that binds to receptors in the body’s cells. Despite the name, vitamin D is actually a secosteroid hormone that targets over 2000 genes. Vitamin D has been shown to have a positive effect on bone health, the immune system, helping prevent some cancers, and reducing inflammation.
Taken orally, vitamin D is absorbed with fat through the intestinal walls as well as in the fat cells of the liver, skin, brain and bones, in amounts sufficient for many months. While not readily available in foods, vitamin D is made in large quantities when sunlight strikes bare skin which is why a deficiency is more common in the winter. Other factors contribute to low vitamin D including malabsorption, common in people with an inflammatory bowel disease. Vitamin D production is also affected by anything that blocks ultra violet light including skin pigment, smog, fog, sunscreen, windows and hats.
Vitamin D Deficiency, Crohn’s and Inflammatory Bowel Diseases
Researchers in a 2009 report wrote that “Western studies show that up to 65 per cent of patients with Crohn’s disease have low serum 25-hydroxy vitamin D concentrations, and 45 per cent of these patients have metabolic bone disease.” In the study, scientists found that vitamin D levels were significantly lower among patients with Crohn’s disease compared to subjects the same and age and gender. Further, D levels in patients with Crohn’s disease were lower in those with severe disease activity and less sun exposure.
In a 2010 study, Dr. John White and his team found evidence to suggest that sufficient vitamin D may counter the effects of Crohn’s disease. Although the researchers were initially studying the effects of D on cancer; the results consistently pointed to D’s impact on the immune system, specifically on the innate immune system, the process that acts as the body’s first defense against microbial invaders, “It’s a defect in innate immune handling of intestinal bacteria that leads to an inflammatory response that may lead to an autoimmune condition,” White explains.
Several other studies suggest a link between vitamin D and inflammatory bowel disease, including a 2006 finding out of Ireland. Researchers found that a high proportion of Crohn’s patients had some level of vitamin D deficiency during late-wintertime. The researchers suggest people with Crohn’s consider taking supplemental vitamin D, particularly patients with small intestinal involvement, quit smoking, get adequate but responsible exposure to summer sunlight, and maintain a body mass index in the normal range.
Vitamin D and Innate Immunity
Vitamin D’s role in intestinal health is believed to involve the beta defensin 2 gene, a gene coding for an important defense molecule of the body. Defensins are part of the arsenal of weapons used by the human immune system. Patients with Crohn’s disease of the colon (colonic CD) have a lower level of beta-defensins in the mucous membranes. Beta defensin encodes an antimicrobial peptide and the NOD2 gene that alerts cells to the presence of invading microbes. If NOD2 is deficient or defective, it can’t attack invaders in the intestinal tract.
An international research team with the Robert Bosch Hospital in Stuttgart and the German Cancer Research Center in Heidelberg discovered a possible cause of the chronic inflammation. They believe Crohn’s patients have one less copy of the protective beta-defensin 2 gene which may be associated with a lower production of the endogenous antibiotic and therefore, lower defensin level. A lower defensin level causes the protective intestinal mucous membrane to become so porous that bacteria can attach to and invade the mucous membrane, which leads to the typical inflammatory hot spots of Crohn’s disease.
Implications for Vitamin D and Inflammatory Diseases
Dr. White believes these findings have significant implications for Crohn’s patients and their families, “Siblings of patients with Crohn’s disease that haven’t yet developed the disease might be well advised to make sure they’re vitamin D sufficient. It’s something that’s easy to do, because they can simply go to a pharmacy, health food store, or online and buy vitamin D supplements. The vast majority of people would be candidates for vitamin D treatment,” he writes.
Click Here for Vitamin D Supplements
Marc J. Servant, a professor at the Université de Montréal’s Faculty of Pharmacy and study collaborator agrees. “This discovery is exciting, since it shows how an over-the-counter supplement such as vitamin D could help people defend themselves against Crohn’s disease,” he says. Although researchers believe many people in the general population are low in vitamin D, patients with Crohn’s disease or other inflammatory bowel disease may be particularly vulnerable to a deficiency.
“Crohn’s Disease: One Gene Copy Too Few Leads To Weakened Defense,” Medical News Today. Accessed April 15, 2010.http://www.medicalnewstoday.com/articles/47508.php
Gilman J, Shanahan F, Cashman KD, “Determinants of vitamin D status in adult Crohn’s disease patients, with particular emphasis on supplemental vitamin D use.” European Journal of Clinical Nutrition. 2006 Jul.
Joseph AJ, George B, Pulimood AB, Seshadri MS, Chacko A. “25 (OH) vitamin D level in Crohn’s disease: association with sun exposure & disease activity. “ Indian J Med Res. August 2009.
White, JH et al., “Direct and indirect induction by 1,25-dihydroxyvitamin D3 of theNOD2/CARD15-beta defensin 2 innate immune pathway defective in Crohn’s disease.” The Journal of Biological Chemistry. January, 2010.
Vitamin D continues to make headline news. Findings suggest adequate levels may break barriers with individuals battling excess weight.
Research reveals a relationship between vitamin D levels in the body, vitamin D intake, and body weight. While the exact relationship is not entirely understood, a growing body of evidence suggests an association between obesity/excess body weight and D levels exists.
In addition, the link is supported by the fact that obesity and low D are co-morbid (occur at the same time) with diseases such as: disease, hypertension, diabetes, osteoarthritis, osteoporosis, depression and even periodontal disease.
Vitamin D Levels Predict Weight Loss Success
In a 2010 study researchers found that adequate vitamin D levels in the body improves weight loss success with a diet program.
“Vitamin D deficiency is associated with obesity, but it is not clear if inadequate vitamin D causes obesity or the other way around,” said the study’s lead author, Shalamar Sibley, MD, MPH, an assistant professor of medicine at the University of Minnesota.
For the study, scientists measured circulating blood levels of vitamin D in 38 overweight men and women before and after the subjects followed a diet plan for 11 weeks consisting of 750 calories a day fewer than their estimated total needs. Subjects also had their fat distribution measured with DXA (bone densitometry) scans.
While the participants’ vitamin D levels were lower than what many experts consider sufficient, the subjects’ baseline, or pre-diet vitamin D levels predicted weight loss in a linear relationship. For every increase of 1 ng/mL in level of 25-hydroxycholecalciferol, the precursor form of vitamin D and a commonly used indicator of vitamin D status, subjects lost almost a half pound (0.196 kg) more on their calorie-restricted diet. For every 1-ng/mL increase in the active or “hormonal” form of vitamin D (1,25-dihydroxycholecalciferol), subjects lost nearly one-quarter pound (0.107 kg) more.
In addition, subjects with higher baseline vitamin D levels (both the precursor and active forms) lost more abdominal fat. The implications of these findings, researchers believe, are promising. “Our results suggest the possibility that the addition of vitamin D to a reduced-calorie diet will lead to better weight loss,” Sibley said.
Obesity and Vitamin D Levels
In another study out of the University of Madrid researchers found that excess body weight was associated with decreasing amounts of vitamin D. Scientists measured the body weight of 61 young, overweight/obese women and randomly assigned them to two different weight control programs: diet V, increased greens and vegetables, or diet C, increased cereals (some of which were enriched with vitamin D).
Taking into account only women with a vitamin D intake below expert-recommended levels, the women who were obese had a significantly lower average serum 25(OH)D concentration than those who weighed less. In addition, group C (increased cereals, some enriched with vitamin D) subjects lost more weight than the Group V subjects.
In another study out of Spain, researchers gathered the following data on 102 children ages nine to 13: height, body weight, body mass index (BMI), waist and hip measurements (to determine the quantity of visceral or abdominal fat), and the thickness of the tricipital and bicipital skinfold (to determine the quantity of subcutaneous fat). Scientists also analyzed the childrens’ diet with a three-day weighed food record and their vitamin D intake as compared to recommended (expert) levels.
Results showed while there was no significant difference in body weight based on vitamin D intake, children who had insufficient levels of D in their body had higher weight, BMI, waist measurement and waist/height ratio than the children with adequate levels of D in their body.
In addition, results showed that children with a body weight, BMI, bicipital skinfold thickness, waist measurement and waist/height ratio above the 50th percentile for each variable were at a greater risk of having a low serum 25(OH)D concentration.
Obesity and Vitamin D Epidemic: Coincidence?
Dr. John Cannell, Director of the Vitamin D Council in his 2004 Newsletter article, “Obesity and Vitamin D,” writes, “One third of Americans are obese. While much of that epidemic is surely due to playing Nintendo instead of baseball, or the consumption of soft drinks instead of water, does that explain it all? Is it a coincidence that the twin epidemics of obesity and vitamin D deficiency are occurring together?”
A growing body of research suggests more than a coincidence. While there are numerous alternative explanations for the findings notes Dr. Cannell, an overwhelming number of studies suggest a link. The following is an incomplete list, for the full list refer to Dr. Cannell’s September 2004 newsletter.
- When aboriginal populations migrate from high altitude (more UV rays to convert to D in the skin) to low altitude, body fat increases.
- Higher calcium intake is consistently associated with lower body weight, as vitamin D significantly increases calcium absorption.
- The combination vitamin D and calcium reduced subsequent spontaneous food intake and increased the metabolism of fat.
- Genetic abnormalities of the vitamin D receptor (called VDR polymorphisms) are associated with body weight and fat mass. Patients with VDR polymorphisms have reduced vitamin D activity at their receptors.
- Blood parathyroid levels, which are elevated in vitamin D deficiency, predict obesity.
- Starting since 1981 studies have consistently shown that 25(OH)D levels are lower in obese subjects.
- Obesity is associated with early death, and low vitamin D levels are more likely in the winter. Scientists have known about and debated the cause of excess winter deaths for years
- Obese subjects obtain lower 25(OH)D levels when exposed to ultraviolet light or when they take supplemental vitamin D. Subjects appeared to deposit some of their vitamin D in their excessive fatty tissue which impaired their ability to raise their 25(OH)D levels.
Whether excess weight contributes to lower levels of vitamin D in the body or low vitamin D causes excess weight is still unclear. Research indicates however, a relationship exists. The implications for weight management and leveraging the effectiveness of a diet program are promising.
The Endocrine Society (2009, June 12), “Successful Weight Loss With Dieting Is Linked To Vitamin D Levels,” ScienceDaily. Retrieved March 18, 2010.
Ortega RM, López-Sobaler AM, Aparicio A, Bermejo LM, Rodríguez-Rodríguez E, Perea
JM, Andrés P, “Vitamin D status modification by two slightly hypocaloric diets in young overweight/obese women.”International Journal of Vitamin & Nutritional Research 2009 Mar;79(2):71-8.
Rodríguez-Rodríguez E, Navia-Lombán B, López-Sobaler AM, Ortega RM,
“Associations between abdominal fat and body mass index on vitamin D status in a
group of Spanish schoolchildren,” European Journal of Clinical Nutrition, 2010 Mar 10.
Cannell, John, MD, The Vitamin D Council, “Obesity and Vitamin D,” The Vitamin D Newsletter, September 17, 2004.
While researchers have found a relationship between insufficient vitamin D, chronic pain, anxiety and depression, the exact causality is still unknown.
Researchers in a 2007 study reported in Clinical Rheumatology that vitamin D deficiency is common in people with fibromyalgia and also occurs more frequently in those with anxiety and depression. Yet research is also emerging that may dispute the once believed link between Seasonal Affective Disorder, its depressive symptoms and D deficiency.
Regardless of the unanswered questions, patients suffering with mood issues and/or chronic muscle pain may want to consider having their 25-hydroxyvitamin D levels tested.
Fibromyalgia, Vitamin D, Anxiety & Depression May Be Linked
People with fibromyalgia often have symptoms of anxiety and depression as well as low levels of vitamin D. In the 2007 study, researchers tested serum vitamin D levels in 75 patients with fibromyalgia. The subjects completed a Fibromyalgia Impact Questionnaire (FIQ) and Hospital Anxiety and Depression Score (HADS). Results showed that patients with vitamin D deficiency scored higher on the HADS .
Research has also linked vitamin D deficiency to patients who suffer with chronic pain. While the relationship between fibromyalgia, pain, anxiety, depression and vitamin D deficiency is somewhat complex and the exact relationship remains unclear, evidence is mounting to suggest that vitamin D plays some role in chronic pain and mood imbalance.
Vitamin D Deficiency, Depression With Seasonal Affective Disorder Research Disputed
Vitamin D continues to gain worldwide attention due to emerging research linking it to more than 2,000 gene processes in the body. Yet evidence has surfaced to challenge vitamin D’s once presumed role in Seasonal Affective Disorder and the associated depressive symptoms. Researchers believe Seasonal Affective Disorder manifests during winter months as a result of lack of sunlight exposure on the skin which then results in vitamin D deficiency.
In a study published in the Journal of Affective Disorders, Dr. Oscar Franco, Assistant Clinical Professor in Public Health and his team, recruited more than 3,000 people and tested levels of vitamin D (25-hydroxyvitamin D) in the blood. Subjects completed a questionnaire to measure depressive symptoms. Researchers found no clear association between depressive symptoms and the concentration of vitamin D in the blood.
“Few studies have explored the association between blood 25-hydroxyvitamin D concentrations and depression in the general population, ” said Dr. Franco. “Previous studies into the effects of vitamin D supplementation have produced mixed results. More studies are still needed to evaluate whether vitamin D is associated with seasonal affective disorders, but our study does raise questions about the effects of taking more vitamin D to combat depressive symptoms.”
A Japanese study conducted in 2009 also found no evidence linking higher blood vitamin D levels with decreased depressive symptoms.
Vitamin D, Mood & The Brain
In a report entitled, “Vitamin D and the occurrence of depression: causal association or circumstantial evidence?” researchers concluded that based on the body of research to date, high doses of supplemental vitamin D may improve mild depressive symptoms. Yet questions persist regarding the following critical study areas of mood regulation:
- how vitamin D affects monoamine function and hypothalamic-pituitary-adrenal axis response to stress
- whether vitamin D supplementation can improve mood in individuals with moderate-to-severe depression
- whether vitamin D sufficiency is protective against incident depression and recurrence.
Investigators in the report suggest it is “premature to conclude that vitamin D status is related to the occurrence of depression. Additional prospective studies of this relationship are essential.”
While the exact relationship between mood disorders, chronic muscle pain and vitamin D deficiency has not be clearly established, evidence suggests that patients with chronic muscle pain, anxiety or depression should at least consider testing their vitamin D levels and supplementing if they are deficient.
Armstrong DJ, Meenagh GK, Bickle I, Lee AS, Curran ES, Finch MB, “Vitamin D deficiency is associated with anxiety and depression in fibromyalgia,” Clinical Rheumatology,2007 Apr.
An Pan, Ling Lu, Oscar H. Franco, Zhijie Yu, Huaixing Li, Xu Lin. “Association between depressive symptoms and 25-hydroxyvitamin D in middle-aged and elderly Chinese., “ Journal of Affective Disorders, 2009.
University of Warwick (2009, March 18). Vitamin D May Not Be The Answer To Feeling SAD. ScienceDaily. Retrieved March 3, 2010.
Bertone-Johnson ER, “Vitamin D and the occurrence of depression: causal association or circumstantial evidence?” Nutritional Review, 2009 Aug.
Copyright Laura Owens. Contact the author to obtain permission for republication.
Researchers are continuing to piece together one of the most mysterious modern day epidemics, autism spectrum disorder, a syndrome affecting one in 110 children. A growing body of evidence suggests low vitamin D levels may play a role.
Scientists studying autism and vitamin D believe there may be an association between a woman’s vitamin D levels during pregnancy, her child’s subsequent vitamin D levels, and autism symptoms. Researchers aren’t however, suggesting a vitamin D deficiency causes autism, rather that a number of incidental studies suggest a link.
Autism Epidemic Presents Five Unexplained Features
The Autism Society of America (ASA) describes autism as “a complex developmental disability that typically appears during the first three years of life and is the result of a neurological disorder that affects the normal functioning of the brain, impacting development in the areas of social interaction and communication skills.” Autism is considered a spectrum disorder because it impacts individuals differently and to varying degrees.
ASA estimates 1 to 1.5 million Americans are impacted by autism, making it a national health crisis costing about $35 billion annually. Yet, despite numerous exhaustive metabolic and genetic evaluations conducted by scientists all over the world, researchers still aren’t able to pinpoint the exact causes.
Dr. John Cannell, Executive Director of the Vitamin D Council, writes that scientific groups have been trying to account for the 20-year increase in autism. Yet any valid theory says Cannell, must account for the following five unexplained features:
- significantly higher concordance (if one has it, the other is likely to have it) rates in identical, but not fraternal, twins
- widely-varying symptoms, even among identical twins
- striking 4:1 male to female sex ratio
- increased rates in blacks
- rapid increase in occurrence rates over the last 20 years
A 2009 Scientific American article “What if Vitamin D Deficiency is a Cause of Autism?” reported that five researchers at Harvard endorsed the vitamin D theory of autism, and that Dr. Darryl Eyles with the University of Queensland joined the expanding list of scientists who support the theory.
Despite the name, “vitamin” D is a secosteroid hormone that directly regulates more than 1,000 human genes. Not readily available in foods, vitamin D is made in large quantities when sunlight strikes bare skin.
Vitamin D Regulates Long List of Genes
Geneticists believe that genetic codes may not properly transfer in children with autism, and that multiple genes aren’t expressed, possibly the result of environmental injury. Vitamin D, it seems, may protect an individual’s genome (entire genetic material) from damage from environmental toxins.
Researchers with the Autism Genetic Resource Exchange (AGRE) identified mutations in four genes within the AGRE families. Two of the genes were shown to be associated with autism and often are involved in forming or maintaining neural synapses, the point of connection between individual neurons. One of the new genes identified was neural cell adhesion molecule 2 (NCAM2). NCAM2 is expressed in the hippocampus of the human brain, a region previously associated with autism.
Dr. Lei, lead researcher on the study, explains the implications, “Studies such as this provide evidence that autism is a genetically based disease that affects neural connectivity.”
Dr. Cannell emphasizes that the vitamin D theory of autism doesn’t downplay the genetic role. In fact, he writes, “Without the genetic tendency for autism, I suspect that severe maternal or early childhood vitamin D deficiency may cause bone abnormalities, as referenced above, [but] with no evidence autism.” A vitamin D deficiency during pregnancy and early childhood may, however, trigger symptoms in a child who is genetically pre-disposed to the disorder.
Autism and Vitamin D Deficiency Linked Through Incidental Findings
In the May 2010 issue of Acta Pædiatrica, Dr. Cannell submitted a paper stating his position regarding D’s role in autism, “I have suggested that the primary environmental trigger for autism is not vaccinations, toxins or infections, but gestational and early childhood vitamin D deficiency (1,2),” he writes.
In the report, Cannell cited several studies that offer incidental evidence (unexpected clinical findings) of a link between D deficiency and autism:
A few of the findings include:
- Boys with autism have unexplained metacarpal bone thickness. At some point these boys developed less cortical bone than normal children, a finding consistent with undetected and untreated childhood or even intrauterine vitamin D deficiency.
- Melanin in the skin is an effective sunblock. Melanin is higher in dark-skinned people. Three of four recent U.S. studies found a higher incidence of autism in black children.
- A Somali immigrant study in Sweden found a higher rate of autism in the Somalian population. These refugees traded family compounds and regular exposure to the equatorial sun for cloistered high-rise apartments, and many of them Muslim, cover their bodies from head to toe (thus received minimal sun exposure).
- Studies showed autism in three U.S. states was higher in areas with more precipitation and clouds (less exposure to sunlight).
- Lower seafood consumption during pregnancy was associated with low verbal intelligence quotient, suboptimum outcomes for prosocial behavior, fine motor, communication and social development scores. Fish is one of the few foods with significant amounts of vitamin D.
- Autism is more common in mothers who take antiepileptic drugs. Antiepileptic drugs are one of the few classes of drugs that interferes with vitamin D metabolism, lowering 25(OH)D levels.
While the government’s advice to the public over the past few decades to use sunblock and to avoid excessive sun exposure to reduce the incidence of skin cancer was well-intentioned, an unfortunate side effect has contributed to two modern day epidemics, vitamin D deficiency and autism spectrum disorder.
“Study adds to evidence that autism has genetic basis,” ScienceDaily, May 3, 2010. Accessed July 23, 2010.
Cannell JJ. “On the Aetiology of Autism.” Acta Paediatrica. May 2010.
Cannell JJ.” Autism and Vitamin D,” Medical Hypotheses 2008, Accessed July 23,2010.
Lite, J., “Vitamin D deficiency soars in the U.S.,” Scientific American, March 23, 2009. Accessed July 23,2010.
Copyright Laura Owens. Contact the author to obtain permission for republication.
In 2008 the online site Pain Treatment Topics released a review of research on the potential benefits of vitamin D for patients with pain conditions, notably musculoskeletal and back issues. Although results varied, researchers agree insufficient vitamin D is an underlying factor in fibromyalgia and other chronic pain conditions.
Chronic pain and vitamin D deficiency linked long ago
Multiple studies link vitamin Ddeficiency to chronic aches and pains, muscle fatigue or weakness, and other disorders including immunity and some cancers (Holick 2003b; ODS 2008; Plotnikoff and Quigley 2003; Reginster 2005; Tavera-Mendoza and White 2007; Vieth 1999).A study presented at the American Society of Anesthesiologists 2007 Annual Meeting reported that about one in four patients with chronic pain also have inadequate blood levels of vitamin D. Patients with insufficient vitamin D also needed higher doses of morphine for longer periods of time.
According to study author W. Michael Hooten, MD, medical director and anesthesiologist at the Mayo Comprehensive Pain Rehabilitation Center in Rochester, Minn., researchers have long known that inadequate levels of vitamin D can cause pain and muscle weakness.“The implications are that in chronic pain patients, vitamin D inadequacy is not the principal cause of pain and muscle weakness,” said Hooten for a press release, “However, it could be a contributing but unrecognized factor.”
The jury is still out on the exact connection between vitamin D and chronic pain but scientists believe it may begin with lower levels of circulating calcium (hypocalcemia) due to inadequate vitamin D. A cascade of biochemical reactions then occurs that hinders bone metabolism and health. Low levels of calcium elevates parathyroid hormones which impairs proper bone mineralization causing a spongy matrix to form under periosteal membranes covering the skeleton.
This gelatin-like matrix can absorb fluid, expand, and cause outward pressure on periosteal tissues, which generates pain since these tissues are highly innervated with sensory pain fibers (Holick 2003b; Shinchuk and Holick 2007; Yew and DeMieri 2002).
Fibromyalgia and Vitamin D Deficiency
The association between low levels of 25-hydroxyvitamin D and non-specific musculoskeletal pain, including fibromyalgia syndrome remains controversial.
In one study, Israeli researchers found no association between women with fibromyalgia and low levels of vitamin D(Tandeter et al. 2009). Yet researches in an earlier study in the Middle East found a significantly greater prevalence of low D concentration in women with fibromyalgia compared to women without fibromyalgia (43% vs 19%).
Yet researchers in the Middle East found that 90% of patients diagnosed with fibromyalgia and/or non-specific musculoskeletal pain treated with vitamin D improved.(Badsha et al. 2009).
One reason for the conflicting evidence is researchers have yet to adequately measure patients’ response to different formulations, doses, and durations of vitamin D. In addition, scientists believe vitamin D receptors have different genetic make up and activity so individuals may respond differently to vitamin D therapy. (Kawaguchi et al. 2002; Videman et al. 2001).
Vitamin D Dosing
Dr. Cannell, Executive Director of The Vitamin D Council recommends supplementing with Cholecalciferol vitamin D3). D3 is the naturally occurring form of vitamin D and is made in large quantities in skin when sunlight strikes it. Dr. Cannell explains that Calcidiol is the only blood test that should be drawn. Doctors can order calcidiol levels although labs will know calcidiol as 25-hydroxyvitamin D.
Take enough vitamin D3 to get 25(OH)D levels above substrate starvation levels, 50 ng/mL or 125 nmol/L. Current recommendations for adults and children are inadequate to maintain optimal health and certainly to treat chronic pain conditions and illness.
Dr. Cannell suggests people supplement with vitamin D before getting their blood tested, then adjust their dose so their 25(OH)D level is between 50–80 ng/ml during both the summer and the winter. These are conservative dosages explains Dr. Cannell. People who avoid the sun, and nearly all dark-skinned people need to increase their dose if their blood levels are still low, even after two months of the above dosage, particularly during the winter months.
Exact levels are difficult to determine because requirements vary by age, body weight, percent of body fat, latitude, skin coloration, season of the year, use of sun block, individual variation in sun exposure, and how sick someone is.
“If you use suntan parlors once a week,” says Dr. Cannell, “or if you live in Florida and sunbathe once a week, year-round, do nothing.” However, if you receive very little UVB exposure the Council recommends the following dosing levels of D3 (maintenance level):
- healthy children under the age of two – 1,000 IU per day*
- healthy children over the age of two – 2,000 IU per day*
- adults and adolescents – 5,000 IU per day.
*The American Academy of Pediatrics recommends 400 mg per day for children.
While the exact relationship between vitamin D and chronic pain syndromes like fibromyalgia isn’t fully understood, most researchers agree that vitamin D deficiency contributes to muscuskeletal pain. Patients and practitioners should consider including vitamin D supplementation in their therapy for patients suffering with chronic pain syndromes.
Another note: Magnesium, malic acid also assist in pain relief for FMS……I use several products but Magnesium Calm is one of my favorites because it works very well, tastes good Click here for magnesium
Dr. Dean who wrote the Magnesium Miracle (Very easy to understand read on why magnesum is critical to our health yet deficient in our soil and therefore our food and often, body) turned me on to the importance of this essential mineral. I take it every night or more often if I need to. It’s a co-factor for an impressive list of functions in our body.
“Vitamin D Inadequacy May Exacerbate Pain,” American Academy of Anesthesiologists, Press Release, October 15, 2007.
Tandeter H, Grynbaum M, Zuili I, Shany S, Shvartzman P., “Serum 25-OH vitamin D levels in patients with fibromyalgia.” Israeli Medical Association Journal, 2009.
Badsha H, Daher M, Ooi Kong K. Myalgias or non-specific muscle pain in Arab or Indo-Pakistani patients may indicate vitamin D deficiency. Clinical Rheumatology. 2009.
Leavitt, Steward, B. MA, PhD., “Vitamin D: A Neglected ‘Analgesic’ for Chronic Musculoskeletal Pain: An Evidence Based Review and Clinical Practice Guideline,” June 2008, http://Pain-Topics.org/VitaminD.
“Vitamin D for Pain: Update of Research Evidence,” Pain Treatment Topics, Accessed: January 10, 2010.
Arvold DS, et al., “Correlation of symptoms with vitamin D deficiency and symptom response to cholecalciferol treatment: a randomized controlled trial,” Endocrine Practice, 2009 May-Jun.
Armstrong DJ, Meenagh GK, Bickle I, Lee AS, Curran ES, Finch MB., “Vitamin D deficiency is associated with anxiety and depression in fibromyalgia,” Clinical Rheumatology. 2006 Jul 19.
- The Sunshine Vitamin (Photo credit, Maggie Smith)
The surge in popularity of vitamin D has largely been prompted by the growing number of doctors recommending patients get their D level checked, and then prescribing supplementation if their level is under 30 ng/mL. In response, the Food and Nutritional Board (FNB) was commissioned to review the current body of vitamin D research. Results were available last week.
The once under-promoted “sunshine vitamin” has been thrust into the spotlight in the last few years, prompting the need for further studies to establish more precise dosing guidelines.
Critics of the revised RDA for vitamin D say the numbers don’t come close to the required amount people need to assist in the prevention of a long list of health conditions associated with a D deficiency.
Cannell feels the FNB is publicizing misinformation and that the panel’s messaging will make people unnecessarily fearful of overdosing, something he says is extremely rare, particularly with cholecalciferol, referred to as D3. D3 is the naturally occurring form of vitamin D that is made in large quantities when sunlight strikes bare skin; it can also be taken as a supplement.